Relatório de estágio curricular supervisionado em clínica médica de pequenos animais

TCC(graduação) - Universidade Federal de Santa Catarina. Campus Curitibanos. Medicina Veterinária.O período de estágio curricular, assim como os estágios extracurriculares realizados durante a graduação é de suma importância, pois, é o momento de vivenciar as experiências que o mercado de trabalho proporciona. O presente relatório tem como objetivo apresentar as atividades desenvolvidas, acompanhadas e pautadas durante o estágio curricular obrigatório em Medicina Veterinária na área de Clínica Médica de Pequenos Animais. O estágio foi realizado em duas partes: a primeira na Clínica Veterinária Bicho Mascote, localizada em Blumenau, no estado de Santa Catarina; e a segunda, no Hospital Veterinário da Universidade de Passo Fundo, localizado em Passo Fundo, no Rio Grande do Sul.The curricular internship period, as well as the extracurricular internships carried out during graduation, is of paramount importance, as it is the time to experience the experiences that the labor market offers. This report aims to present the activities developed, monitored and guided during the mandatory curricular internship in Veterinary Medicine in the area of the Small Animal Medical Clinic. The internship was held in two parts: the first at Clínica Bicho Mascote, located in Blumenau, in the state of Santa Catarina; and the second at the Veterinary Hospital of the University of Passo Fundo, located in Passo Fundo, in Rio Grande do Sul

Celulite juvenil canina: Relato de Caso

TCC(graduação) - Universidade Federal de Santa Catarina. Campus Curitibanos. Medicina Veterinária.A celulite juvenil canina é uma dermatose imunomediada incomum que acomete cães com até seis meses de idade. A doença se apresenta na forma de vesículas, pústulas, crostas principalmente em região da face. Relata-se o caso de um cão, sem raça definida, de 2 meses de idade, com quadro clínico intenso de edema facial, alopecia, otite bilateral não purulenta, edema prepucial e lesões crostosas e pruriginosas. Os exames de raspado de pele superficial e profundo deram negativos para a presença de ácaros. O exame histopatológico caracterizou uma dermatite crônica supurativa associada a intensa perifoliculite compatível com Celulite Juvenil Canina.Canine juvenile cellulitis is an uncommon immune-mediated dermatosis that affects dogs up to six months of age. The disease presents itself in the form of vesicles, pustules, crusts, mainly on the face. We report the case of a 2-month-old mixed breed dog with an intense clinical picture of facial edema, alopecia, non-purulent bilateral otitis, prepucial edema and crusty and pruritic lesions. Superficial and deep skin scraping tests were negative for the presence of mites. Histopathological examination characterized a chronic suppurative dermatitis associated with intense perifolliculitis compatible with Canine Juvenile Cellulitis

Visceral Leishmaniasis in Dogs

Background: Canine visceral leishmaniasis (CVL) is a zoonosis of variable clinical presentation, either in systemic or cutaneous form. Clinical signs include anorexia, ophthalmopathies, and chronic kidney disease. In the state of Santa Catarina, the foci are concentrated in the capital and its adjacencies, in the east side of the state. The objective of this study is to outline the first three reported cases of CVL in the municipality of Curitibanos, since there are no reports to date in the region of the mountainous plateau, in the middle west of Santa Catarina.Cases: All dogs were treated at the Veterinary Clinic School of the Federal University of Santa Catarina, Campus Curitibanos. The animals, two males and one female, belonged to the same tutor, resided in Curitibanos, and were attended between 2016 and 2020. In the first case, attended in 2016, the complaint was of eye and skin changes about three months ago. The animal lived in an urban environment and came from Uruguaiana, Rio Grande do Sul. On physical examination, the animal presented skin peeling, wet and crusty lesions, bloody discharge in the ears and nasal hyperkeratosis, as well as signs suggestive of uveitis. In this case, euthanasia was carried out. The second case had complaints of respiratory, eye changes, hyporexia, and polydipsia. The dog was prostrate, dehydrated, with lymphadenomegaly and respiratory disorders, compatible with bacterial pneumonia. Bilateral corneal edema confirmed uveitis. Upon return, the animal remained dehydrated with enlarged lymph nodes. In the aspiration of the lymph nodes, suggestive forms of Leishmania sp. were observed. The recommended confirmatory tests were performed, leading to a definitive diagnosis of CVL. The patient was treated with miltefosine, but later died. The third case was attended for general evaluation after a positive diagnosis for CVL during an epidemiological survey of the second case. The animal was alert, tachycardic, and tachypneic with hyperemic mucous membranes. Miltefosine-based treatment and permanent use of deltamethrin-impregnated collar were prescribed and ovariohysterectomy was carried out. The patient is clinically well. In the search for vectors, in no place or moment of search, referring to the cases, vectors for CVL were found.Discussion: It is suggested that patients 2 and 3 are autochthonous cases, whose transmission form has not been fully elucidated, and vector transmission cannot be ruled out, as well as other less common forms of transmission. For case 1, it is suggested that it is an allochthone case, probably imported from the Uruguaiana region, where the disease is endemic. The conduct of a positive result for CVL is euthanasia, with the exception of dogs that have guardians who wish to perform treatment, but not always possible due to the high cost of miltefosine, the only drug approved for dog therapy in Brazil. In the first case, the owner opted for euthanasia, since in 2016 there was no possibility of treatment. For the last two cases, a treatment cycle was performed as recommended by the guidelines. Regarding the municipality of Curitibanos, in the first case diagnosed in 2016, the animal came from Uruguaiana. In conclusion, this study aimed to report the clinical and epidemiological characteristics related to the first three patients with CVL reported in Curitibanos

HIPERTENSÃO SITUACIONAL EM CÃES DÓCEIS ADULTOS

Systemic arterial hypertension (SAH) is a silent disease that can affect cats and dogs. Although well described in felines, “white coat syndrome”, or situational hypertension, is little reported in dogs. Thus, this paper aims to show the importance of stress in the measurement of blood pressure from adult dogs. The study was conducted with 46 dogs of both sexes, docile, adults, apparently healthy. After anamnesis, physical examination, ambiance, and friendly management of animals, systolic blood pressure (SBP) was measured by the doppler method in the thoracic limb. Several measurements were made to obtain an arithmetic average. Animals up to 160mmHg of SBP, in the first measurement, were considered normotensive (36 dogs, corresponding to 78.26%). For those with SBP higher than or equal to 160mmHg (10 dogs, equivalent to 21.74%), a second measurement was performed after 15 to 30 minutes, with the animals at rest. Therefore, six of these dogs presented SBP between 154mmHg and 200mmHg (one considered prehypertense and five hypertensives) and four normotensives. For the animal with prehypertension and the hypertensives, complementary examinations were performed, in which four dogs were diagnosed with chronic kidney disease and two with family dyslipidemia of the Schnauzers. Thus, it can be concluded that among the 46 dogs evaluated, there were 36 normotenses (78.26%), a one prehypertense (2.17%), five hypertensives (10.87%), and four with situational hypertension (8.7%). Therefore, regarding dogs in a hospital environment, it is important to perform friendly management and, when necessary, more than one moment of SBP measurement to avoid erroneous diagnoses of SAH.A hipertensão arterial sistêmica (HAS) é uma enfermidade silenciosa que pode afetar gatos e cães. Embora bastante descrita em felinos, a “Síndrome do Jaleco Branco”, ou hipertensão situacional, é pouco relatada em cães. Assim, este trabalho tem como objetivo mostrar a importância do estresse na aferição da pressão arterial de cães adultos. O estudo foi realizado com 46 cães de ambos os sexos, dóceis, adultos, e aparentemente saudáveis. Após anamnese, exame físico, ambientação e manejo amigável dos animais, mensurou-se a pressão arterial sistólica (PAS) pelo método Doppler no membro torácico. Foram feitas várias aferições para obtenção de média aritmética. Animais com até 160mmHg de PAS, na primeira aferição, foram considerados normotensos (36 cães, correspondente a 78,26%). Para os que tiveram PAS maior ou igual a 160mmHg (dez cães, equivalente a 21,74%), realizou-se um segundo momento de aferição, após 15 a 30 minutos, com os animais em repouso. Assim, seis desses cães apresentaram PAS entre 154mmHg e 200mmHg, sendo, então, um considerado pré-hipertenso e cinco hipertensos, e outros quatro considerados normotensos. Para o animal com pré-hipertensão e para os hipertensos, realizaram-se exames complementares, pelos quais quatro cães foram diagnosticados com doença renal crônica e dois com dislipidemia familiar dos Schnauzers. Dessa forma, pode-se concluir que, dos 46 cães avaliados, 36 apresentaram-se normotensos (78,26%), um pré-hipertenso (2,17%), cinco hipertensos (10,87%) e quatro com hipertensão situacional (8,7%). Portanto, para cães em ambiente hospitalar, é importante realizar um manejo amigável e, quando necessário, mais de um momento de aferição de PAS para evitar diagnósticos errôneos de HAS

Preclinical validation of a new hybrid molecule loaded in liposomes for melanoma management

The aggressiveness of melanoma and lack of effective therapies incite the discovery of novel strategies. Recently, a new dual acting hybrid molecule (HM), combining a triazene and a ʟ-tyrosine analogue, was synthesized. HM was designed to specifically be activated by tyrosinase, the enzyme involved in melanin biosynthesis and overexpressed in melanoma. HM displayed remarkable superior antiproliferative activity towards various cancer cell lines compared with temozolomide (TMZ), a triazene drug in clinical use, that acts through DNA alkylation. In B16-F10 cells, HM induced a cell cycle arrest at phase G0/G1 with a 2.8-fold decrease in cell proliferation index. Also, compared to control cells, HM led to a concentration-dependent reduction in tyrosinase activity and increase in caspase 3/7 activity. To maximize the therapeutic performance of HM in vivo, its incorporation in long blood circulating liposomes, containing poly(ethylene glycol) (PEG) at their surface, was performed for passively targeting tumour sites. HM liposomes (LIP HM) exhibited high stability in biological fluids. Preclinical studies demonstrated its safety for systemic administration and in a subcutaneous murine melanoma model, significantly reduced tumour progression. In a metastatic murine melanoma model, a superior antitumour effect was also observed for mice receiving LIP HM, with markedly reduction of lung metastases compared to positive control group (TMZ). Biodistribution studies using 111In-labelled LIP HM demonstrated its ability for passively targeting tumour sites, thus correlating with the high therapeutic effect observed in the two experimental murine melanoma models. Overall, our proposed nanotherapeutic strategy was validated as an effective and safe alternative against melanoma.</p

Educação Sexual: Avaliação da eficiência de ações educativas em unidade escolar da cidade de Jacobina - BA / Sexual Education: Evaluation of the efficiency of educational in school unit in the city of Jacobina – BA

Este estudo objetivou avaliar a eficiência do desenvolvimento de ações educativas relacionadas com temas da sexualidade, em especial os métodos contraceptivos, para adolescentes em uma unidade escolar da cidade de Quixabeira no estado da Bahia. Foi realizada uma oficina envolvendo 11 adolescentes com idades entre 14 e 19 anos. Os resultados mostraram que, no sexo feminino, 3 adolescentes já possuíam vida sexual ativa (37%), sendo que desse total, 67% afirmam fazer uso de algum método contraceptivo. Com relação ao sexo masculino, os 3 adolescentes afirmaram ter vida sexual ativa (100%), porém apenas 33% afirmaram fazer uso de algum método contraceptivo. Os contraceptivos mais conhecidos por ambos os sexos foram: camisinha, pílula anticoncepcional e pílula do dia seguinte. Foi observado uma modificação positiva no conhecimento antes e depois da oficina ministrada. Sendo assim, pode-se concluir que há a necessidade de investimento em estratégias educativas desde o início da adolescência, com o objetivo de estimular o uso de preservativos e contraceptivos, reduzindo, de modo significativo, a vulnerabilidade desse público

Remdesivir and corticosteroids in the treatment of hospitalized COVID-19 patients

okCoronavirus disease 2019 (COVID-19) is a pandemic infection caused by the newly discovered severe acute respiratory syndrome coronavirus 2. Remdesivir (RDV) and corticosteroids are used mainly in COVID-19 patients with acute respiratory failure. The main objective of the study was to assess the effectiveness of remdesivir with and without corticosteroids in the treatment of COVID-19 patients. We conducted a prospective observational study, including adult patients consecutively hospitalized with confirmed COVID-19 and acute respiratory failure. Patients were divided according to treatment strategy: RDV alone versus RDV with corticosteroids. The primary outcome was the time to recovery in both treatment groups. We included 374 COVID-19 adult patients, 184 were treated with RDV, and 190 were treated with RDV and corticosteroid. Patients in the RDV group had a shorter time to recovery in comparison with patients in the RDV plus corticosteroids group at 28 days after admission [11 vs. 16 days (95% confidence Interval 9.7-12.8; 14.9-17.1; p = .016)]. Patients treated with RDV alone had a shorter length of hospital stay. The use of corticosteroids as adjunctive therapy of RDV was not associated with improvement in mortality of COVID-19 patients.publishersversionpublishe

a preliminary report

© European Association of Hospital Pharmacists 2021. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVES: Since the outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the pressure to minimise its impact on public health has led to the implementation of different therapeutic strategies, the efficacy of which for the treatment of coronavirus disease 2019 (COVID-19) was unknown at the time. Remdesivir (REM) was granted its first conditional marketing authorisation in the EU in June 2020. The European Medicines Agency (EMA) and local health authorities all across the EU have since strongly recommended the implementation of pharmacovigilance activities aimed at further evaluating the safety of this new drug. The objective of this study was to evaluate adverse drug reactions (ADRs) attributed to either REM or hydroxychloroquine (HCQ) in patients hospitalised for COVID-19 in Centro Hospitalar de Lisboa Ocidental, a Portuguese hospital centre based in Lisbon. We present the preliminary results reporting plausible adverse effects of either HCQ or REM. METHODS: An observational cohort study was carried out between 16 March and 15 August 2020. Participants were divided into two cohorts: those prescribed an HCQ regimen, and those prescribed REM. Suspected ADRs were identified using an active monitoring model and reported to the Portuguese Pharmacovigilance System through its online notification tool. The ADR cumulative incidence was compared between the two cohorts. RESULTS: The study included 149 patients, of whom 101 were treated with HCQ and the remaining 48 with REM. The baseline characteristics were similar between the two cohorts. A total of 102 ADRs were identified during the study period, with a greater incidence in the HCQ cohort compared with the REM cohort (47.5% vs 12.5%; p<0.001). Causality was assessed in 81 ADRs, all of which were considered possible. CONCLUSIONS: Real-world data are crucial to further establish the safety profile for REM. HCQ is no longer recommended for the treatment of COVID-19.publishersversionpublishe

Fatores de risco para o surgimento da hipertensão arterial sistêmica: saber para prevenir / Risk factors for the arising of systemic arterial hypertension: knowing to prevent

Entende-se como Hipertensão Arterial Sistêmica (HAS), a elevação da pressão nas artérias mediante motivos distintos, como por exemplo a obesidade, o tabagismo, dieta rica em sódio, estresse, falta de atividade física e entre outros, podendo levar ao desenvolvimento de cardiopatias, nefropatias e muitas outras doenças. Sendo utilizados como parâmetros para classificar os pacientes: pré-hipertenso (120/80 a 139/89 mmHg); hipertenso estágio 1 (140/90 a 159/99 mmHg); hipertenso estágio 2 (160/100 a 179/109 mmHg) e hipertenso estágio 3 (180/110 mmHg ou mais); esses valores são descobertos através da aferição da pressão que tem o objetivo de identificar na artéria braquial o ponto sistólico e diastólico (1). Diante disso, se torna imprescindível para o médico conhecer os valores e os fatores de risco para orientar seus pacientes a seguir um melhor tratamento. Sendo assim esse resumo foi feito por meio de revisão bibliográfica, utilizando as plataformas Google Acadêmico e Scielo. O resultado foi a discussão sucinta dos três fatores mais recorrentes na sociedade nos dias atuais, sendo eles obesidade, ingesta de sódio e tabagismo. A HAS se tornou um grande inconveniente para a saúde pública, visto que predispõe o surgimento de diversas enfermidades, como por exemplo, cardiopatias, insuficiência renal crônica, aterosclerose e entre outras. Os motivos para o surgimento da hipertensão são muitas vezes multifatoriais, diante disso, o atual resumo abordará os principais fatores que iniciam tal doença (2). Dentre esses motivos destaca-se a obesidade, a mesma é causadora de inflamações assintomáticas e crônicas, isso ocasiona alterações no sistema renina-angiotensina-aldosterona (SRAA), que por sua vez é grande envolvida no controle da pressão arterial, com isso tem-se um aumento da vasoconstrição, que consequentemente eleva a resistência vascular periférica, surgindo assim a HAS (3). Dietas ricas em sódio também são grandes contribuintes para o surgimento da Hipertensão, pois também agem no SRAA, de forma que aumentam a sua ativação (4). Outro importante fator que contribui para a elevação da pressão é o tabagismo, visto que a nicotina, uma das principais substâncias encontrada no cigarro, age no aumento da liberação de noradrenalina, adrenalina e vasopressina, grandes responsáveis pelo controle da pressão arterial e também da atividade cardíaca (5). Portanto, conclui-se que a obesidade, a grande ingesta de sal e o tabagismo são grandes contribuintes para o surgimento da HAS, tornando necessária uma grande mudança de hábito por parte dos indivíduos, também sendo importante um bom planejamento e uma contínua melhora nos programas de saúde pública, tudo objetivando a melhora da saúde da população e também a redução dos empecilhos causados pela HAS.